Billing code 43843: Gastric restrictionMedicare rate & RVUs in Florida
Reports a gastric-restrictive operation for morbid obesity that limits stomach capacity without gastric bypass and is not vertical-banded gastroplasty.
CMS doesn’t publish an office rate for 43843 in Florida.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 43843 covers
This code describes an operation for morbid obesity that reduces the stomach’s capacity to restrict food intake, without creating a gastric bypass and without using the vertical-banded gastroplasty technique. A bariatric or general surgeon typically performs the procedure in an operating room. The operative report should identify the procedure actually performed and the changes made to the stomach so the service can be distinguished from bypass, vertical-banded gastroplasty, and revision surgery.
Select this code from the operative technique, not simply from the patient’s obesity diagnosis or the intended weight-loss effect. Documentation should support the indication, anatomy treated, and work performed. CMS assigns a 90-day global period, including the day-before preoperative visit and related postoperative care during that period. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Assistant-at-surgery and co-surgeon payment may be allowed; team surgery is not permitted under this code’s CMS rules.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 43843 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | Unavailable | $1,359.99 |
| Miami | Unavailable | $1,502.43 |
| Rest Of Florida | Unavailable | $1,284.78 |
How the 43843 rate is calculated
Each of 43843’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 43843
RVUs × geographic indexes × conversion factor
Work20.68
20.68 RVUs× 1.000 GPCI
Practice expense9.91
9.91 RVUs× 1.000 GPCI
Malpractice5.53
5.53 RVUs× 1.000 GPCI
Adjusted RVUs
36.1200
Conversion factor
$33.4009
Medicare rate
$1,206.44
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 43843
43843 has a 90-day global period: related visits in that window are included in the surgery payment.
CMS payment indicators · 43843
Gastric restriction
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 090 | Major surgery: the day before, the day of, and 90 days after are included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 2 | Paid. |
| Co-surgeons (62) | 2 | Permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
| Split (54/55/56) | 0.09/0.81/0.10 | Share of the payment for pre-op, the procedure itself, and post-op care. |
Global surgery period · 43843
Gastric restriction
90-day global period ends
Dec 30, 2026
Covers Sep 30, 2026 through Dec 30, 2026 (92 days, including the day before surgery).
Visit on Oct 31, 2026
Day 30 of the 90-day post-op period: related follow-up care is included in the surgical payment.
Pre-op dayGlobal period
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
43843 without 51 · national facility
$1,206.44
Gastric restriction
43843-51 · Second procedure: 50%
$603.22
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
43843 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 43842Gstr rstcv px v-banded gstp
- 43842 is specifically for vertical-banded gastroplasty. Code 43843 is for a gastric-restrictive operation other than that technique and without gastric bypass.
- 43845Duodenal switch
- 43845 describes a duodenal-switch operation. Use 43843 when the operation is restrictive without a gastric bypass or duodenal-switch reconstruction.
- 43846Gastric bypass
- 43846 includes gastric bypass with a short-limb Roux-en-Y reconstruction. Code 43843 describes restriction without a bypass.
- 43848Bariatric revision
- 43848 is for revision of a prior open gastric-restrictive procedure. Code 43843 describes the restrictive operation itself, rather than revision.
43843 billing questions
How is this code distinguished from 43842?
43842 describes vertical-banded gastroplasty. Use 43843 for a qualifying gastric-restrictive operation other than that specific technique, without gastric bypass.
Can this code be used for a gastric bypass?
No. The service is a restrictive operation without gastric bypass. Choose a bypass code when the operative procedure includes the bypass reconstruction.
What documentation supports reporting 43843?
The operative report should describe the restrictive technique, the stomach anatomy altered, and the indication for surgery. It should make clear that the procedure was neither vertical-banded gastroplasty nor gastric bypass.
How does the 90-day global period affect postoperative billing?
The CMS global period includes the day-before preoperative visit and 90 days of related postoperative care. Those related services are included in the global surgical package.
Can an assistant or co-surgeon be reported?
CMS indicates that assistant-at-surgery payment may be made and that co-surgeons are permitted. Team surgery is not permitted under this code’s CMS rules.
What happens when another procedure is performed in the same session?
Under the standard multiple-procedure reduction, the highest-valued procedure is paid in full and other procedures are paid at 50% when performed in the same session.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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